high ventricular rate
Tracing
Manufacturer Abbott
Device PM
Field Management of atrial arrhythmias
N° 33
Patient
59-year-old man with obstructive hypertrophic cardiomyopathy implanted with an AccentTM DR pacemaker aimed at reducing the left intraventricular gradient; episode of sudden syncope; highlighting of a high ventricular rate episode at the time of the syncope.
Graph and trace
At the beginning of the tracing, atrial sensing and ventricular pacing; VT episode with atrioventricular dissociation; acceleration of the VT rate which becomes very rapid (240 bpm) thus explaining the syncope.
Other articles that may be of interest to you
This tracing poses the difficult question of recording bursts of non-supported ventricular tachycardia in pacemaker patients. For this patient, it would appear legitimate to discuss upgrading to an implantable ICD. The indication is furthermore warranted in this patient with hypertrophic cardiomyopathy and syncopal VT episode.